Organization Active NPI

Educare Nutrition and Diabetes LLC

  • Metabolic Nutrition Registered Dietitian
  • Woodland Hills, CA
National Provider Identifier
1376800938
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Legal business name
EDUCARE NUTRITION AND DIABETES LLC
Practice address
22554 Ventura Blvd
205
Woodland Hills, CA 91364-1413
Phone
(818) 330-4021
NPI assigned
Apr 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrea Milton, RD, CDENPI 1861795791
Title
Owner
Phone
(818) 330-4021

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Pediatric Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1004X 859147 CA
Renal Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1005X
Metabolic Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1006X Primary

Addresses

Primary practice location

22554 Ventura Blvd
205
Woodland Hills, CA 91364-1413

Mailing address

22554 Ventura Blvd
205
Woodland Hills, CA 91364-1413
Phone (818) 330-4021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000163 CA Part B Supplier - Clinic/Group Practice 1951566991 Receives reassigned benefits from 1 practitioner
Practice locations: Woodland Hills, CA

National Provider Directory

National Provider Directory

Locations

22554 Ventura Blvd
Ste 205
Woodland Hls, CA 91364
Phone (818) 222-2080

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1376800938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22554 VENTURA BLVD",
            "address_2": "205",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641413",
            "telephone_number": "818-330-4021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22554 VENTURA BLVD",
            "address_2": "205",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641413",
            "telephone_number": "818-330-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCARE NUTRITION AND DIABETES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "MILTON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-330-4021",
        "authorized_official_credential": "RD, CDE"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "CA",
            "license": "859147",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.